Kidney Week

Abstract: TH-PO605

Vitamin D Metabolites and Risk of Cardiovascular Disease in CKD

Session Information

• Hypertension and CVD: Epidemiology, Risk Factors, Prevention
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1502 Hypertension and CVD: Clinical‚ Outcomes‚ and Trials

Authors

• Hsu, Simon, University of Washington, Seattle, Washington, United States

Simon Hsu,

• Bansal, Nisha, University of Washington, Seattle, Washington, United States

Nisha Bansal,

• Brown, Julia, University of Illinois Chicago, Chicago, Illinois, United States

Julia Brown,

• Denburg, Michelle, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Michelle Denburg,

• Feldman, Harold I., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Harold I. Feldman,

• Ginsberg, Charles, University of California San Diego, La Jolla, California, United States

Charles Ginsberg,

• Hoofnagle, Andrew N., University of Washington, Seattle, Washington, United States

Andrew N. Hoofnagle,

• Isakova, Tamara, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Tamara Isakova,

• Kestenbaum, Bryan R., University of Washington, Seattle, Washington, United States

Bryan R. Kestenbaum,

• Lidgard, Benjamin, University of Washington, Seattle, Washington, United States

Benjamin Lidgard,

• Robinson-Cohen, Cassianne, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Cassianne Robinson-Cohen,

• Zelnick, Leila R., University of Washington, Seattle, Washington, United States

Leila R. Zelnick,

• de Boer, Ian H., University of Washington, Seattle, Washington, United States

Ian H. de Boer,

Background

The ratio of 24,25-dihydroxyvitamin D₃ to 25-hydroxyvitamin D₃ (vitamin D metabolite ratio, VDMR) is a measure of vitamin D status that may reflect tissue-level vitamin D receptor activation.

Methods

We conducted a longitudinal study to test associations of the VDMR and other vitamin D metabolites with risk of cardiovascular disease (CVD) in a random subset of participants from the Chronic Renal Insufficiency Cohort (CRIC; n=1111). Serum 24,25-dihydroxyvitamin D₃, 25-hydroxyvitamin D₂ and D₃, and 1,25-dihydroxyvitamin D₂ and D₃ were measured by liquid chromatography-tandem mass spectrometry 1 year after enrollment (baseline for the current analysis). The primary outcome was composite CVD (heart failure, myocardial infarction/revascularization, stroke, and peripheral arterial disease). We used Cox regression to test associations of the VDMR, total 25-hydroxyvitamin D (25(OH)D), and total 1,25-dihydroxyvitamin D (1,25(OH)₂D) with risk of CVD in participants without prevalent CVD (n=729). We also examined associations of these metabolites with left ventricular mass index (LVMI) measured at the year 1 study visit using linear regression. Analytic models adjusted for demographics, co-morbidity, medications, estimated glomerular filtration rate (eGFR) and proteinuria.

Results

The mean age of the study cohort was 59 years, 43% were female, and 42% were Black. There were 187 composite CVD events over a mean (standard deviation) follow-up of 9.6 (4.6) years among participants without prevalent CVD. Lower VDMR and 1,25(OH)₂D were associated with risk of CVD prior to, but not after adjustment for eGFR and proteinuria (Table 1). Neither 25(OH)D, the VDMR, nor 1,25(OH)₂D was associated with LVMI after full covariate adjustments.

Conclusion

The VDMR, 25(OH)D, and 1,25(OH)₂D were not significantly associated with risk of incident CVD or with LVMI.

Funding

• NIDDK Support